Thursday 19 Jul 2018 | 12:29 | SYDNEY
Thursday 19 Jul 2018 | 12:29 | SYDNEY

Reader riposte: Medics at war

18 May 2010 08:36

Dr Nick Chapman writes:

Whilst having the greatest respect for Major Gen (Retd) Jim Molan and enjoying his regular contributions to The Interpreter, I feel compelled to respond to his recent post on Craig Jurisevic's newly released book, 'Blood on My Hands: A Surgeon at War'. 

Jim's brief review of the book and broader musings on the place of medicos in armed conflict, as well as on the existence of a moral imperative to act in the face of 'evil', contain not only some truly outrageous assertions but also what appears to be a basic misrepresentation of the facts.

Craig Jurisevic initially went to the Balkans with the International Medical Corps to provide medical care to refugees in Albania, but ended up training and fighting with the Kosovo Liberation Army, a role that saw him kill Serb soldiers. When asked to comment by The Australian, the President of the Australian Medical Association responded by saying that Jurisevic's actions as a combatant ultimately conflicted with his medical role.

Jim Molan characterises this response as 'bizarre'; the grounds on which he does so are totally unapparent to me. 

It is rather a cliché to quote the principle of primum non nocere (first, do no harm), and yet it is necessarily the guiding principle of medical practice. Implicit (though not, as is commonly thought, explicit) in the Hippocratic oath, it is further reinforced in the Declaration of Geneva, an oath in which a doctor also swears that, 'the health and life of my patient will be my first consideration', and that 'I will not permit considerations of religion, nationality, intervene between my duty and my patient.'

I suspect that some of these assertions may seem a trifle lily-livered to Jim, given that he appears to suggest that we as a medical profession are prone to shirking our duty to take up arms, but he should nonetheless be aware that these are oaths sworn by every Australian medical graduate on their admission to the profession. To suggest that it is 'bizarre' to contend that there is a fundamental conflict between these sworn commitments and an active combat role is simply outlandish.

Jim's next assertion – that Australian medics are combatants, and should be involved in fighting whenever they’re not 'too busy treating the wounded' – shows either a frightening ignorance of the laws of war or a wilful misrepresentation of the facts. 

Medical personnel are explicitly protected under the First Geneva Convention, which affords them non-combatant status as well as requiring them to treat wounded combatants from all sides and care for enemy prisoners. 

Australian medics, like those of many other nations, do indeed carry weapons: this is provided for by Art. 22(1) of the Convention, which allows them to use those arms only 'in their own defence, or in that of the wounded and sick in their charge.' Any use of their weapons in an offensive capacity is a violation of their non-combatant status, and thus leaves them unprotected under the Geneva Conventions and open to direct attack, with obvious implications for their ability to provide medical care.

Craig Jurosevic is free to choose sides and take up arms, providing he doesn't do so whilst wearing the insignia of the Red Cross (or Crescent). To claim that one can do so without compromising the principles of medical ethics and impartiality, however, is simply wrong. 

To suggest that a doctor can do more to confront evil in the world by picking up a rifle than a scalpel is, perhaps, a philosophical question more open to debate. I know which option I would argue for, though.

Photo by Flikr user tim166, used under a Creative Commons license.